36D1046736 CLIA NUMBER - COMPREHENSIVE PAIN CARE CENTER INC

Laboratory Demographics

CLIA Number: 36D1046736

Facility Name: COMPREHENSIVE PAIN CARE CENTER INC

Facility Address:
4804 LEAVITT ROAD
LORAIN, OH
ZIP 44053
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Facility Phone Number: 440 989-2066

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1124095112

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	36D1046736
LAB Type	Physician Office
Facility Name	COMPREHENSIVE PAIN CARE CENTER INC
Street	4804 LEAVITT ROAD
City	LORAIN
State	OH
ZIP	44053
Phone	440 989-2066
CertificateType	4
CertificateEffectiveDate	10/18/2023
CertificateExpirationDate	10/17/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024